Kasich waiting on Senate for his Obamacare replacement plan

Friday

Mar 17, 2017 at 10:53 AMMar 18, 2017 at 10:41 AM

Catherine Candisky The Columbus Dispatch @ccandisky

As U.S. House Republicans scheduled a Thursday vote on Obamacare’s replacement, Ohio Gov. John Kasich’s quest to mount a counter-effort that would have preserved Medicaid expansion appears to have fallen flat — attracting the support of only three other Republican governors.

Kasich, along with Govs. Rick Snyder of Michigan, Brian Sandoval of Nevada and Asa Hutchinson of Arkansas, outlined their concerns in a letter Thursday to GOP congressional leaders, urging them to dump the House plan and consider one the governors drafted.

The GOP plan "provides almost no new flexibility for states, does not ensure the resources necessary to make sure no one is left out, and shifts significant new costs to states," the governors wrote to House Speaker Paul Ryan, R-Wis., and Senate Majority Leader Mitch McConnell, R-Ky.

"We support fundamental reform of the Medicaid entitlement. We have worked to develop a proposal that accomplishes this and addresses issues of equity for expansion and non-expansion states."

The governors said they want more flexibility over their Medicaid programs to help manage planned cuts in federal aid. They want authority to reduce enrollment, impose work requirements and other conditions for coverage, and allow the use of private contractors to perform services.

"Each state must be permitted to pursue Medicaid transformation in its own way," they wrote.

Friday, President Donald Trump agreed to add new Medicaid restrictions to the House bill, bolstering support from some conservative lawmakers but still leaving unclear whether it will have enough votes to pass next week.

One leading House conservative said the alterations were insufficient and claimed enough allies to sink the measure, while support among GOP moderates remained uncertain.

"My whip count indicates that there are 40 no's," enough to defeat the bill, said Rep. Mark Meadows, R-N.C., who leads the hard-line House Freedom Caucus. He said the change "doesn't move the ball more than a couple yards on a very long playing field."

Across the Capitol, Senate GOP leaders were at least two votes shy of what they'd need to prevail.

In an interview Friday night on CNN, Kasich said he did not "think this bill passes the Senate. I sure hope it doesn’t pass the Senate.

"Maybe it will pass the House, maybe it won’t," Kasich said. "But when it gets to the Senate, we have to involve both parties in the discussion. If you don’t have both parties working on a major issue, it’s not sustainable."

Congressional Democrats remain solidly opposed to the GOP effort.

Saying Trump has called him about the bill "and we talked about it," Kasich predicted that Trump is "going to fight … to get this House bill through. But I think at the end of the day, I believe that he would be a negotiator.”

The House bill would repeal much of former President Barack Obama's Affordable Care Act, including its tax penalties for people who don't buy insurance and expansion of Medicaid, the federal-state health program for the poor. The proposal would create new tax credits that would be less generous than current federal subsidies for many consumers, and repeal levies on the wealthy and medical firms that helped pay for expansion of coverage to 20 million Americans.

The latest deal between Trump and lawmakers would let states choose to impose work requirements on childless adults among Medicaid's roughly 60 million recipients and allow states to accept a lump-sum federal payment for Medicaid, instead of an amount that would grow with the number of beneficiaries. The program currently costs the federal government around $370 billion annually and automatically covers costs, no matter the amount.

The Obama administration refused to allow work requirements, saying they were not consistent with the goals of Medicaid, but several Republican governors have expressed interest in imposing such requirements on certain Medicaid beneficiaries — able-bodied adults without minor children.

Ohio, among 31 states and the District of Columbia to expand Medicaid under Obamacare,stands to lose billions in federal aid.

According to the Congressional Budget Office, the bill would increase the number of people without health insurance by 24 million by 2026, while reducing spending by $337 billion during that time.

Ohio would lose $19 billion to $26 billion in federal Medicaid funding under the proposal, causing massive cuts in eligibility, services or payments to health-care providers, according to an analysis by the Cleveland-based Center for Community Solutions.

More than 700,000 previously uninsured low-income adults have received health coverage under Medicaid expansion, pushing Ohio's total enrollment to more than 3 million.

But Trump again expressed his support for the House GOP framework.

‘‘I’m 100 percent behind this,’’ Trump said at the White House, where he met with House members in the conservative Republican Study Committee. At a news conference hours later, the president predicted, ‘‘It’s going to be passed, I believe — I think substantially and pretty quickly.’’

The House is tentatively scheduled to vote Thursday, exactly seven years after Obama signed the Affordable Care Act into law. As some lawmakers came out for the measure on Capitol Hill, some others — in the House and Senate — were stepping forward to oppose it.

Information from Dispatch Washington bureau chief Jack Torry and The Associated Press was included in this story.

ccandisky@dispatch.com

@ccandisky

(

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.